Dementia Ethical Issues

Nearly 135 million people worldwide will be impacted by dementia by 2050 (Robinson, Tang, Taylor,. 2015). Dementia is not a disease, it is an overall term that describes a wide range of symptoms associated with the decline in memory and thinking skills. Dementia is a progressive illness that results in the loss of one’s sense of self (Burns, Byrne, Ballard, Holmes, 2002). The two most common forms of dementia are Alzheimer’s disease and Vascular dementia. Dementia is progressive and people with dementia experience complications with short-term memory, keeping track of personal items, paying bills, taking care of themselves and daily tasks (Haigh, Mytton, 2016). Due to the rising number of individuals developing dementia, it is causing major challenges in the healthcare systems and society (Angermeter, Luck, Then, Riedel-Heller, 2016). Utilizing psychotropic medications are often ineffective or harmful to the individual, therefore, many patients decide to utilize sensory therapy as a form of treatment instead (Livingston, Kelly olmes, et al., 2014). Caregivers of individuals with dementia can also experience health consequences related to caregiving at the end of life. Spousal caregivers are 40.5% higher odds of experiencing frailty as a result of caregiving (Carr, Dassel, 2017). Dementia does not only affect the individual, it affects those around them, society, and the healthcare system.

Key legislation that relates to the fulfilment of rights and choices and also minimises the risk of harm to an individual with dementia is:

Long-term care assists individuals who cannot adequately perform their routine activities of daily living. These activities include dressing, bathing, walking, meal preparation, and taking medications ( Batnitzk,A.,Hayes,D.,& Vinall,P.E. 2014,(c. 5.1). These services are typically for clients over the age of 65 years old and is used to promote independence and security for those who cannot take care of their needs due to illness or debility (c.6.1). The type of provider will depend on the type of care a client needs. For instance, some elderly people that need help with food preparations or everyday activities will request to stay at home and have a family member take care of them. This is one way that long-term care is rendered but is unpaid.

People who have dementia are not aware of requirements for living. They can forget to do the essential things that are vital. Taking medicines, hygiene and even eating are often forgotten. They can get lost or hurt and not understand what is necessary to correct a situation. Turning on the cooker or water and forgetting to turn it off again, locking doors, crossing streets etc can all be dangerous even deadly. In the same way as you would not think an infant capable of self care, a person with dementia cannot be either. Considering the facts that they cannot act in the manner of a

- Describe how cognitive functional and emotional changes associated with dementia can affect eating drinking and nutrition:

Dementia is a very common disorder that is more common in the older population. For people aged 60-69 the dementia rate is 1in 100, but in people over 80 the rate is 1in 6(A.Smith, 2011). Dementia is a terminal illness and the prognosis is grim, suffers are only expected to live 3 to 5 years after diagnosis (A.Smith, 2011). Dementia is divided into three stages early, middle and late. People can be in the late stage for many years. During the late stage the dementia patient suffers from a lot of different issues including but not limited to dysphagia, self-feeding, and eating problems. Nearly 50 percent of patients with dementia lose their ability to self-feed within 8 years after the onset of the disease (S.A. Thomas 2014).We know that malnutrition is a serious problem when it comes to dementia

Enhancing dignity in the care of people with dementia Professor Lesley Baillie Florence Nightingale Foundation Chair of Clinical Nursing Practice, London South Bank University and University College :London Hospitals Plan Types of dignity • Human dignity: the dignity that all humans have and cannot be taken away • Social dignity: experienced through interaction - dignity-of-self and dignity-inrelation (Jacobson 2007) • So for people with dementia: • We must acknowledge and respect their human dignity • We must recognise how their dignity is affected by how they feel and by our interactions with them  What is the meaning of dignity? How does it feel to have dignity?

1.3 Outline how other health and emotional conditions may affect the nutritional needs of an individual with dementia

A balanced diet is important to people with dementia because if they do not have a nutritional diet then it can worsen their condition. Weight loss, nutritional deficiencies and inadequate fluid intake can all have a negative effect on a person’s dementia. It is the care assistances job to make sure that the individuals get the correct diet they each need.

1 Descride how congnitive, functional and emotional changes asspociated with dementia can affect eating, drinking and nutrition.

Symptom management of Dementia at end of life is often sub-optimal, although symptom burdens may be similar to cancer, chronic obstructive pulmonary disease (COPD) or advanced heart failure. Dementia may exist with several co-morbid conditions, and death may occur from various causes (Jones et al., 2015). Ethical issues arise in the work place a lot and they are something that can be hard to navigate your way around. Knowing what the right thing to do can be a hard decision to make as a nurse. There are many aspects that go into making an ethical decision when it comes to your patients well being. Ethical issues are not black and white, they are complex, and the right decision might not be the easiest one to make. Dementia is

There are ethical issues everywhere one turns, so ethical issues in information systems should not be a new concept or surprise to anyone. There are emerging ethical issues and as information systems progress, new ways to access information becomes available. These issues can play a role in our personal and professional lives, as well as in government and social aspects. There are also ethical issues involved in the medical field. Two big ethical issues that are becoming more prevalent in discussions are tracking devices used for people with dementia and electronic medical records. There are benefits to both of these, but they also have disadvantages as privacy and patients’ rights come into question. These ethical issues are new and therefore

So,… My ethical dilemma is to decide whether to ask, or address, what might be very early signs of dementia with my dad. I’ve known him for a long time now and I’m not sure if little signs like telling the same stories over again are really signs of this (I do the same thing sometimes, I forget who I told what or when I told them, hopefully I don’t have dementia…), or if they are just normal tendencies and possibly a sign of not seeing each other as much as we did in the past. I mentioned during his last visit that pretty soon he would be able to hide his own Easter eggs and it did not go over well. Is he worried about the same thing? What have my parents talked about with each other without telling me?

Nurses should assess psycho-social factors, which could lead to nutritional alterations. Factors such as loss of caregiver support, social isolation, limited access to food, an inability to cook and prepare food because of cognitive problems, or inability to recognize hunger may contribute to patient’s malnutrition. Collateral history from a caregiver and a home visit can provide invaluable insight into these issues (Wells & Dumbrell, 2006). Knowledge of the normal and pathological changes in cognition that occur in aging is an essential background to understanding interventions to optimize cognition in older adults. (Williams & Kemper, 2010). Nutrition has been identified as a critical factor in successful cognitive aging as well as in abnormal cognitive decline, including dementia. Thus, nurses need to assess cognitive aging as a basis for educating clients about their nutritional needs and for developing interventions to promote cognitive and physiological wellbeing. There is strong evidence that a balanced nutrition can improve cognitive performance in older adults (Scott at al., 2006).

Alzheimer’s disease is not a natural part of aging. It is the most common cause of progressive dementia, due to the degeneration of nerve cells in the brain and shrinkage of brain matter. Risk of developing Alzheimer’s disease is increased by older age, genetic factors and several medical risks factors. Many studies have also suggested that dietary and life style factors may influence risk, raising the possibility that preventive strategies for Alzheimer’s disease. Persons with Alzheimer’s disease have impaired ability to recognize hunger, thrust or satiety. They are prone to dehydration.